RT Journal Article
SR Electronic
T1 C-reactive Protein and Future Risk of Clinical and Molecular Subtypes of Colorectal Cancer
JF Cancer Epidemiology Biomarkers & Prevention
JO Cancer Epidemiol Biomarkers Prev
FD American Association for Cancer Research
SP 1482
OP 1491
DO 10.1158/1055-9965.EPI-19-1339
VO 29
IS 7
A1 Bodén, Stina
A1 Myte, Robin
A1 Harbs, Justin
A1 Sundkvist, Anneli
A1 Zingmark, Carl
A1 Löfgren Burström, Anna
A1 Palmqvist, Richard
A1 Harlid, Sophia
A1 Van Guelpen, Bethany
YR 2020
UL http://cebp.aacrjournals.org/content/29/7/1482.abstract
AB Background: Inflammation has been implicated in colorectal cancer etiology, but the relationship between C-reactive protein (CRP) and colorectal cancer risk is unclear. We aimed to investigate the association between prediagnostic plasma CRP concentrations and the risk of clinical and molecular colorectal cancer subtypes.Methods: We used prospectively collected samples from 1,010 matched colorectal cancer case–control pairs from two population-based cohorts in Northern Sweden, including 259 with repeated samples. Conditional logistic regression and linear mixed models were used to estimate relative risks of colorectal cancer, including subtypes based on BRAF and KRAS mutations, microsatellite instability status, tumor location, stage, lag time, and (using unconditional logistic regression) body mass index.Results: CRP was not associated with colorectal cancer risk, regardless of clinical or molecular colorectal cancer subtype. For participants with advanced tumors and blood samples <5 years before diagnosis, CRP was associated with higher risk [OR per 1 unit increase in natural logarithm (ln) transformed CRP, 1.32; 95% confidence interval (CI), 1.01–1.73]. CRP levels increased over time, but average time trajectories were similar for cases and controls (Pinteraction = 0.19).Conclusions: Our results do not support intertumoral heterogeneity as an explanation for previous inconsistent findings regarding the role of CRP in colorectal cancer etiology. The possible association in the subgroup with advanced tumors and shorter follow-up likely reflects undiagnosed cancer at baseline.Impact: Future efforts to establish the putative role of chronic, low-grade inflammation in colorectal cancer development will need to address the complex relationship between systemic inflammatory factors and tumor microenvironment, and might consider larger biomarker panels than CRP alone.